Antiviral therapy after complete response to chemotherapy could be efficacious in HCV-positive non-Hodgkin's lymphoma

J Hepatol. 2008 Oct;49(4):557-63. doi: 10.1016/j.jhep.2008.06.025. Epub 2008 Jul 21.

Abstract

Background/aims: Prevalence of HCV infection in non-Hodgkin's lymphoma is high. The impact of antiviral therapy on the natural history of this subgroup of lymphomas after a successful chemotherapy regimen is still an argument of debate.

Methods: We retrospectively examined 343 chemotherapy-treated patients referred to our centre for five consecutive years. Clinical and histological characteristics, disease free-survival (DFS) and overall-survival (OS) were compared in HCV-positive (69/343) and HCV-negative (274/343) patients. Twenty-five HCV-positive patients received antiviral treatment following chemotherapy discontinuation. Uni- and multivariate analyses were performed.

Results: 20% of lymphomas were HCV-positive. Indolent histology was prevalent in the HCV-positive group (p<0.05); no significant differences in OS or DFS were found between the two groups; in HCV-positive subjects, antiviral therapy, was associated with a longer DFS (p<0.05); none of the HCV-positive subjects who achieved a virological response experienced any lymphoma relapse; 29% of non responders did; at multivariate analysis, the independent factors related to a better clinical outcome were: indolent histology at the onset of lymphoma and antiviral therapy.

Conclusions: Antiviral treatment in HCV-positive non-Hodgkin's lymphoma may be an important strategy to reinforce the results of a successful chemotherapy regimen; further studies are needed to validate this combined approach.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Cohort Studies
  • Female
  • Hepacivirus / pathogenicity
  • Hepatitis C / drug therapy*
  • Humans
  • Interferons / therapeutic use
  • Kaplan-Meier Estimate
  • Liver / pathology
  • Liver / virology
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / virology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Ribavirin / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Antineoplastic Agents
  • Antiviral Agents
  • Ribavirin
  • Interferons